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Lean leadership: an ethnographic study

Kjeld Harald Aij (Department of Anaesthesiology & Operative Care, VU University Medical Center, Amsterdam, The Netherlands.)
Merel Visse (Ethics of Care, University of Humanistic Studies, Utrecht, The Netherlands.)
Guy A.M. Widdershoven (Department of Medical Humanities, VU University, Amsterdam, The Netherlands.)

Leadership in Health Services

ISSN: 1751-1879

Article publication date: 5 May 2015




The purpose of this study is to provide a critical analysis of contemporary Lean leadership in the context of a healthcare practice. The Lean leadership model supports professionals with a leading role in implementing Lean. This article presents a case study focusing specifically on leadership behaviours and issues that were experienced, observed and reported in a Dutch university medical centre.


This ethnographic case study provides auto-ethnographic accounts based on experiences, participant observation, interviews and document analysis.


Characteristics of Lean leadership were identified to establish an understanding of how to achieve successful Lean transformation. This study emphasizes the importance for Lean leaders to go to the gemba, to see the situation for one’s own self, empower health-care employees and be modest. All of these are critical attributes in defining the Lean leadership mindset.


In this case study, Lean leadership is specifically related to healthcare, but certain common leadership characteristics are relevant across all fields. This article shows the value of an auto-ethnographic view on management learning for the analysis of Lean leadership. The knowledge acquired through this research is based on the first author’s experiences in fulfilling his role as a health-care leader. This may help the reader examining his/her own role and reflecting on what matters most in the field of Lean leadership.



This study was supported by LIDZ, a Dutch network for Lean healthcare, and the authors acknowledge the support of Emedits Global Ltd (Steven Bradshaw) for the editing of proper English of this manuscript.


Aij, K.H., Visse, M. and Widdershoven, G.A.M. (2015), "Lean leadership: an ethnographic study", Leadership in Health Services, Vol. 28 No. 2, pp. 119-134.



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Copyright © 2015, Emerald Group Publishing Limited

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